Divalproate augmentation in lithium-resistant rapid cycling mania in four geriatric patients.
This report describes four geriatric patients, with rapid cycling bipolar disorder, who were treated successfully with divalproex sodium in combination with lithium carbonate, noting that both drugs were necessary for clinical remission of symptoms. Divalproex sodium may actually enhance the sensitivity to lithium carbonate in this population, potentially leading to treatment with lower lithium concentrations. This strategy has an advantage in enabling a greater safety range in the use of lithium carbonate in elderly patients. This report further raises questions as to the nature of rapid cycling illness in the "old-old" population.
Schneider
A L
AL
Pharmacology Research Institute, Northridge, CA 91324-4625, USA. pri@lainet.com
Wilcox
C S
CS
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000523:psychology; D003221:Confusion / Q000188:drug therapy / Q000523:psychology; D004334:Drug Administration Schedule; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016651:Lithium Carbonate / Q000627:therapeutic use*; D008297:Male; D014635:Valproic Acid / Q000627:therapeutic use*
D016651:Lithium Carbonate; D014635:Valproic Acid